Histologic analysis of pediatric tonsil and adenoid specimens: is it really necessary?

Int J Pediatr Otorhinolaryngol. 2009 Apr;73(4):547-50. doi: 10.1016/j.ijporl.2008.11.001. Epub 2009 Feb 3.

Abstract

Objective: To evaluate the incidence of unexpected histologic findings in routine tonsillectomy and adenoidectomy specimens.

Methods: A retrospective medical record review was performed at a tertiary care children's hospital. The pathology records of 2062 children who underwent tonsil or adenoid surgery were analyzed and the final histologic diagnosis was recorded.

Results: Four unexpected histologic findings were found on routine tonsil and adenoid specimens. None were clinically significant. A review of the literature shows a very low rate (0.015%) of unexpected clinically significant diagnoses in pediatric adenotonsillectomy specimens.

Conclusions: Given rarity of unexpected clinically significant diagnoses in pediatric adenotonsillectomy specimens, the cost and effort of analyzing each specimen histologically is difficult to justify.

MeSH terms

  • Adenoidectomy / economics
  • Adenoids / pathology*
  • Adenoids / surgery
  • Adolescent
  • Biopsy / economics*
  • Child
  • Child, Preschool
  • Costs and Cost Analysis
  • Diagnosis, Differential
  • Female
  • Hospitals, Pediatric
  • Humans
  • Incidence
  • Incidental Findings*
  • Infant
  • Male
  • Palatine Tonsil / pathology*
  • Palatine Tonsil / surgery
  • Retrospective Studies
  • Tonsillectomy / economics
  • United States